I am not appalled or incensed, and really struggle to think why you would be.
A boy is in pain. He is being treated by doctors. They are not “fabricating suffering”. This is the reality of MSF, and represents what they do in a completely honest fashion.
To answer your first three questions, the audio is not real to that situation, nor is the house pictured the actual place where the care is being given. The advert has been ‘made’ by the ad agency. The text has also been added and presents a situation – it is not fact.